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Theresa Jackson
NPI 1568709335 · on the registry since 2013
Practice
- Address
- 3550 Centerville Hwy
Snellville, GA 30039 - Phone
- (770) 736-7806
- Organisation at this address
- Publix Super Markets Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 183500000X
183500000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2013-01-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia